Excess nitrogenous waste products in the blood and their toxic effects. Kidney impairment (see Bright disease; diabetes mellitus; hypertension; kidney failure; nephritis) or disorders that hinder urine excretion (e.g., prostatic disorders) allow urea and other protein waste products to accumulate. Symptoms usually start with fatigue and loss of concentration. They may include itching and muscle twitches; dry, flaky, yellowish skin; dry mouth, metallic taste, and ammonia breath; and nausea, vomiting, diarrhea, and constipation. Advanced stages affect the nervous, cardiovascular, and respiratory systems and can lead to hypertension, seizures, heart failure, and death. If the underlying disorder cannot be treated, dialysis or kidney transplant may be required.
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Uremia is a term used to loosely describe the illness accompanying kidney failure (also called renal failure). In kidney failure, urea and other waste products, which are normally excreted into the urine, are retained in the blood. Early symptoms include anorexia and lethargy, and late symptoms can include decreased mental acuity and coma. It is usually diagnosed in kidney dialysis patients when the glomerular filtration rate, a measure of kidney function, is below 50% of normal.
Azotemia is another word that refers to high levels of urea, but is used primarily when the abnormality can be measured chemically but is not yet so severe as to produce symptoms. Uremia can also result in fibrinous pericarditis. There are many dysfunctions caused by uremia affecting many systems of the body, such as blood (lower levels of erythropoietin), sex (lower levels of testosterone/estrogen) and bones (osteoporosis and metastatic calcifications).